| NPI | 1346243185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA051718) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60778) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2024-06-06 |